Bipolar transurethral resection of bladder tumours

Markić D, Krpina K, Oguić R, Sotošek S, Španjol J, Ahel J, Rubinić N, Trošelj M, Maričić A,

Department of Urology, University Hospital Rijeka, Rijeka, Croatia

Bladder cancer is the fourth most common noncutaneous malignancy in men with increasing incidence. Currently transurethral resection of bladder tumour (TURBT) represents the treatment of choice for low-grade, low-stage tumours. TURBT is not only a treatment for superficial bladder tumours, but is also used for the diagnostic evaluation of most bladder tumors of all stages and grades. TURBT is most commonly performed with a monopolar electrocautery resecting loop and hypotonic irrigation fluid. Recently, bipolar energy with saline irrigation has been used for transurethral resection of bladder tumours and here we report our experience with this technique.

We reviewed the records of all patients with bladder tumours treated with bipolar TURBT at Department of Urology, University Hospital Rijeka in the last two years. Bipolar TURBT was performed for diagnostic and therapeutic purposes in all patients. Resected tissue was examined by a pathologist who recorded tumour stage and grade. Follow-up was from 1 to 22 months after operation.

From June 1st 2012 to April 22nd 2014 we performed 81 bipolar TURBT procedures in 73 patients. The mean age of the patients was 66,6 years (range 29-90 years). Superficial tumour was diagnosed in 75% of patients. Five patients (6,2%) had a significant postoperative bleeding and four (4,9%) of them need transurethral revision to achieve adequate haemostasis. Neither one patient developed TUR syndrome or urethral stricture postoperatively.

Transurethral resection of bladder tumours with bipolar energy is safe and effective technique in the treatment of bladder tumours. According to our limited experience monopolar energy TURBT can be successfully replaced with bipolar energy but the higher rate of haematuria using bipolar technique need to be studied in the future.